But before anyone panics, let’s take a step back and look at the facts. Health officials are making plans in case bird flu becomes the next pandemic. In fact, Dawn O’Connell, assistant secretary for preparedness and response at the Department of Health and Human Services, told me that the federal government is far better prepared to respond to pandemic influenza than it is to COVID-19.
First, it is much easier to obtain personal protective equipment such as masks, gowns, and goggles through commercial markets today than it was before the coronavirus outbreak. But even if those supply chains are in a “pinch,” O’Connell said there is plenty in the Strategic National Stockpile to provide to farms, health systems and other affected organizations.
This stockpile also includes the antiviral drug Tamiflu, which is effective against seasonal influenza and is expected to be effective against H5N1. Tamiflu, like antiviral drugs for COVID-19, reduces the chance of a severe influenza infection if taken as soon as symptoms appear. However, unlike treatment for COVID-19, Tamiflu can also be given to close contacts of infected people to prevent them from getting sick.
O’Connell explained that there are tens of millions of courses of Tamiflu in the national stockpile. The federal government is also providing funding for each state to build its own stockpile, meaning there are “tens of millions” more treatments available. And this is in addition to the over-the-counter Tamiflu, which can be purchased at pharmacies with a doctor’s prescription.
Another important preventive measure is vaccination. O’Connell, who also oversees vaccine preparation efforts, said the federal government has contracts with three manufacturers that can produce avian influenza vaccines. Each company uses his three platforms approved by the Food and Drug Administration to develop egg-based, cell-based, and recombinant vaccines. This means that if one platform doesn’t work, or if a company runs into production issues, there are other options.
Additionally, because a significant number of influenza strains have already been identified, the federal government maintains a library of antigens used in vaccines to elicit an immune response against the influenza virus. Every year, scientists try to predict which strains of seasonal flu shots will be prevalent that fall. It then analyzes existing antigens, tests them against strains, and selects the best match to produce that year’s flu vaccine.
O’Connell said two antigens in the library appear to match H5N1. The federal government also has adjuvants, which are components of vaccines needed to boost the body’s immune response to the shot, in preparation for avian influenza vaccinations.
In fact, the federal government has already developed hundreds of thousands of doses of the vaccine and is ready to deploy it against the H5N1 strain in birds. There are an additional 10 million doses that need to be finalized, which could be completed within weeks.
If you need more, you have two options. The first is to produce more vaccines using the same technology as seasonal vaccines. O’Connell estimates manufacturers could produce 125 million doses within 130 days. This vaccine is a two-dose vaccine, so it only covers a portion of the U.S. population.
The second option is to pursue mRNA vaccines, which can be produced much faster than traditional platforms. Even if these vaccines are no longer as effective or durable as older vaccines, they could be useful as a first vaccine, buying time to manufacture additional vaccines.
Of course, there is a third option: ramp up vaccine production now. Mr O’Connell has a good answer as to why this isn’t happening. To produce hundreds of millions of doses of bird flu vaccine, manufacturers would have to stop making seasonal flu vaccines. This would also require significant additional funding from Congress. “We need to make sure we are in a position to justify it,” she said.
There is no evidence of human-to-human transmission, and the Centers for Disease Control and Prevention assesses the risk to humans as low. Therefore, we have not yet reached the point where we need to ramp up vaccine production. But if that’s the case, it’s reassuring to know that the United States is in a better position to respond than it was at the beginning of the coronavirus pandemic.
